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You are here: Home / Getting ready for a return to more normal health care

Getting ready for a return to more normal health care

We may not have realized it, but all of us have participated these last 12 months in one of the major health care experiments in recent times. It may reshape the practice of modern medicine, and could have big impacts on individual well-being and pocketbooks.

When the coronavirus pandemic raged in 2020, the U.S. medical system at times all but shut down, save for emergency treatment of those infected with Covid-19. Patients and doctors, hospitals, and labs canceled or postponed untold numbers of tests and procedures. This situation has gone up and down, especially as different parts of the country have become viral hot spots.

Researchers only now are piecing together the severity and duration of the medical system’s stoppage. But we are likely to get an unprecedented look from 2020 about the trillions of dollars we spend as a nation each year on health care. How many of these dollars are necessary? And how many are wasteful and driven by the medical establishment’s pursuit of profits?

If you feel bad or experience certain symptoms, common sense says to get in touch with your doctor and seek medical care — ASAP. But as the pandemic quells and greater normalcy returns, patients may need to be as skeptical as ever about their medical care, participating as fuller partners in their treatment, researching carefully, and asking loads of questions about tests and procedures ordered for them. This month’s newsletter: why and how.

As patients return to regular care, can they avoid medicine’s costly excesses?

The New York Times just carried a sobering story, quoting cancer specialists who say they are treating a wave of advanced cases in which patients might have benefited from earlier care had fear of Covid-19 infection not kept them away from doctors’ offices and hospitals.

Dr. Lucio N. Gordan, the president of the Florida Cancer Specialists & Research Institute, one of the nation’s largest independent oncology groups, told the newspaper: “There’s no question in practice that we are seeing patients with more advanced breast cancer and colorectal cancer.”

He and other specialists emphasized, however, that they are only beginning to compile the comprehensive data to support their anecdote-based concerns about postponed cancer screening and treatment. Worries about it have grown for months. This includes a published viewpoint in June 2020 by a respected clinician who estimated — he said conservatively — that the pandemic would be blamed for 10,000 excess deaths from breast and colon cancer in the next decade, with many of the fatal cases showing up in the next year or two.

Separating ‘signal’ from ‘noise’

That would be grim news, if true. But Dr. Scott Ramsey, a co-director of the Hutchinson Institute for Cancer Outcomes Research in Seattle, had a different take on the pandemic’s broader health care effects, as the New York Times reported in a separate article. He took note of the explosion of costly, invasive, and unnecessary medicine that patients in this country long have endured and told the newspaper:

“If we can separate signal from noise, maybe we can learn there are a lot of things we don’t need to do. Maybe patients will do better.”

It may be complicated to sort out the pandemic’s various effects on U.S. health care, partly because we access the system in varied ways — including with emergency, urgent, and routine care, preventative programs, elective procedures, and chronic condition treatment.

Patients prioritize their care, even in the best of times, depending on an array of factors. During the pandemic, fear of infection alone may have kept us away in droves from doctors and hospitals. But as the crisis deepened and wore on, its economic damage also may have slashed medical care because patients just could not afford it. Tens of millions of Americans lost employer-provided health coverage when laid off in 2020’s economic crash. Patients also may have struggled to get to appointments when public transportation closed, or, later, eliminated routes and slashed service hours.

Numerous studies throughout the last year, many based on opinion surveys, have documented how and why patients curtailed their medical care, reporting, too, how they said they also think their health suffered.

Finding a faster resumption of care

At the same time, research by the independent, nonprofit RAND Corporation raises interesting issues about heightened concerns about cancer screening, specifically, and why patients may need to be wary of doctors’ dire and even self-serving comments about pandemic-related delays in care. As the investigators reported:

“Screenings for breast cancer and colon cancer dropped dramatically during the early months of the coronavirus pandemic, but use of the procedures returned to near-normal levels by the end of July 2020, according to a new study. Analyzing insurance claims from more than 6 million Americans with private health coverage, researchers found that mammography rates among women aged 45 to 64 declined by 96% during March and April 2020 as compared to January and February. Similarly, the weekly rate of colorectal cancer screenings among adults aged 45 to 64 and older declined by 95% during the period.

“By the end of July 2020, however, the rate of mammograms among women had rebounded and was slightly higher than it had been before the pandemic was declared. The rate of colonoscopies also rebounded, although it remained below pre-pandemic levels, and did not rebound enough to offset initial reductions in care. ‘These are the first findings to show that, despite real fears about the consequences of drop-off in cancer screens, health facilities figured out how to pick this back up after the initial pandemic restrictions,’ said Ryan McBain, the study’s lead author …”

Beware and act on these symptoms

For patients, experience and rigorous research agree: Do not risk your health by ignoring important warning signs from your body and mind. If you experience symptoms linked with risky health or mental health conditions, you should get in touch with your doctor as soon as possible. Here are some checklists that will help.

Cancer

The American Cancer Society says patients should seek medical care quickly if experiencing these symptoms:

 Fatigue or extreme tiredness that doesn’t get better with rest.  Weight loss or gain of 10 pounds+ for no known reason  Eating problems such as not feeling hungry, trouble swallowing, belly pain, or nausea and vomiting  Swelling or lumps anywhere in the body Thickening or lump in the breast or other parts  Pain, especially new or with no known reason, that doesn’t go away or worsens  Skin changes such as a lump that bleeds or turns scaly, a new mole or a change in a mole, a sore that does not heal, or a yellowish color to skin or eyes (jaundice). Persistent cough or hoarseness Unusual bleeding or bruising for no known reason  Change in bowel habits, such as constipation or diarrhea, that doesn’t go away or a change in how your stools look  Bladder changes such as pain when urinating, blood in the urine or needing to go more or less often  Fever or nights sweats  Headaches, vision, or hearing problems  Mouth changes such as sores, bleeding, pain, or numbness

Circulatory

The American Heart Association says these symptoms should be dealt with urgently:

Heart attacks

Discomfort in the center of the chest that lasts more than a few minutes or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain. Pain or discomfort in one or both arms, the back, neck, jaw, or stomach.  Shortness of breath, with or without chest discomfort  Breaking out in a cold sweat, nausea, or lightheadedness.

Stroke

Think of the acronym FAST: Facial drooping, Arm weakness, Speech difficulties and Time Face drooping or one side of face numb. Can the person smile? Is one arm weak, or numb? Ask the person to raise both arms. Does one arm drift downward?  Is the person’s speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.” Is it repeated correctly?  If the person shows any of these symptoms, even if they go away, call 911 and get them to the hospital immediately. Time is brain.

Mental health

The National Alliance on Mental Health offers high cautions about these signs:

 Excessive worrying or fear Feeling excessively sad or low.  Confused thinking or problems concentrating and learning  Extreme mood changes, including uncontrollable “highs” or feelings of euphoria.  Prolonged or strong feelings of irritability or anger.  Avoiding friends and social activities. Difficulties understanding or relating to others Changes in sleeping habits or feeling tired and low energy.  Changes in eating habits, including increased hunger or lack of appetite. Changes in sex drive.  Difficulty perceiving reality (delusions or hallucinations).  Inability to perceive changes in one’s own feelings, behavior, or personality (”lack of insight” or anosognosia) Overuse of alcohol or drugs.  Multiple physical ailments without obvious causes (headaches, stomach aches, vague and ongoing “aches and pains”)  Thinking about suicide.  Inability to carry out daily activities or handle daily problems and stress.  An intense fear of weight gain or concern with appearance

From pandemic’s adversity, opportunity

Optimists see opportunities for needed change, even in the calamitous circumstances caused by the coronavirus pandemic that has killed almost 550,000 Americans and infected more than 30 million of us as of late March 2020.

Deferred care, for example, could lead patients to ask important questions that could change the practice of medicine and their own health, as the seasoned New York Times columnist Jane Brody posited in a recent column. She quoted Dr. William H. Shrank of Humana, a national health insurance company, and lead author of a report on waste in the current health care system:

“The pandemic has fostered ‘an opportunity for patients to take on a more active role in their care,’ Dr. Shrank said … Covid-based limitations gave prospective patients a chance to consider what procedures they really needed. Most elective surgeries were put on hold when hospitals and medical personnel were overwhelmed with the challenges of caring for a tsunami of patients infected with a deadly virus.

“Dr. Shrank suggested that people ask themselves, ‘How did you do without the procedure?’ Maybe you didn’t really need it, at least not now. Maybe instead of costly surgery for a bad back or bum knee, physical therapy, home exercises, or self-administered topical remedies could provide enough relief to permit desired activities. Does every ache and pain require a doctor visit?”

Brody also wrote this of herself: “Short of a catastrophic sign like crushing chest pain or unexplained bleeding, my approach is to wait a week or two to see if a new symptom resolves without medical intervention. I awoke one January morning with pain in my right wrist and forearm so intense I couldn’t brush my teeth. Perhaps I did too much crocheting or slept on it wrong. Ice didn’t help, but I applied an anti-inflammatory ointment, took two naproxen, wrapped my wrist in a brace from the local pharmacy and refrained from crocheting for two days, by which time the pain had resolved.

“When professional health care is needed, new approaches have become more acceptable during the pandemic, Dr. Shrank said. Emergency room visits and hospital admissions declined precipitously (though not always wisely by people with symptoms of a heart attack). Noting that many patients can be treated effectively at home by a visiting nurse, Dr. Shrank said, ‘No one wants to go to the hospital or a rehab facility if there’s a good alternative.’”

Problems spike when doctors overdo it

Over testing, over diagnosis, misdiagnosis, and over treatment plagued U.S. medicine in pre-pandemic times. It’s a topic worthy of a whole newsletter but know this: When it comes to medical screenings and tests, more isn’t always better. Early detection may not be all that helpful with some conditions and diseases, contrary to popular belief. And it’s, well, malarkey that doctors practice defensive medicine against medical malpractice lawsuits  by ordering excessive tests or procedures, just in case.

As health officials try to contain medical services’ soaring costs, they have zeroed in on an important gateway: over-screening, over-diagnosing, misdiagnosing, and over-treating that add $200 billion in unnecessary expenses to our care, with over-treatment costing 30,000 lives a year of older (Medicare) patients alone.

It isn’t taking patients’ temperatures or checking their blood pressure or getting them one or two tests that reformers assail. It is the cascade of costly, invasive, painful, and unneeded tests and procedures that follow. Every medical intervention carries with it an element of risk — indeed, some experts estimated that medical errors ranked as the No. 3 killer of Americans, claiming 250,000 lives annually in pre-pandemic times. It makes no sense to play the odds with your well-being by loading up your exposure in the health system.

Look at your own bills, too, and see how a routine, relatively inexpensive doctor visit can blow up with added testing costs. These might include tests for cholesterol (costing as much as $1,000), Vitamin D deficiency ($50 or so), diabetes (blood sugar $20), breast (mammograms, often covered by insurance but $20 to $60), or prostate cancer (PSA test $40).

Patients can find helpful, credible resources

Unnecessary and low-value tests abound so much that reformers have launched countermeasures. These include the Choosing Wisely campaign started after a 2012 report by the Institute of Medicine estimated that $750 billion — about 30% of all health spending in 2009 — was wasted on unnecessary services and other issues, such as excessive administrative costs and fraud.

Choosing Wisely, which now has a convenient app, asks clinicians themselves what tests and procedures, if ordered, patients should have a “conversation” with doctors about. That’s because the initiative’s respected specialists in a range of fields want patients to get treatment, they say, that is: “Supported by evidence, not duplicative of other tests or procedures already received, free from harm, and truly necessary.” The group has, for example, questioned excessive prostate and breast cancer screening in older patients and doctors’ rush to subject patients with low back pain to complex and costly imaging studies.

The federal government also assembles a blue-chip panel — the U.S. Preventive Services Task Force — to review careful research, consult with experts, and make “evidence-based recommendations” to the public in understandable ways about “clinical preventive services such as screenings, counseling services, and preventive medications.”

The task force and Choosing Wisely both may get maximum public attention when they weigh in on much disputed topics like mammograms or prostate screens. But they both provide deep and accessible resources for patients wanting comprehensible discussions of tests and procedures doctors may order.

So, when you feel comfortable enough to resume the former pace of your pre-pandemic medical appointments, do some research and ask questions of your doctor or her staff, and you may better protect your health and your pocketbook.

Doctors owe you explanations 

Remember: Your doctor must provide you the fundamental right to informed consent. This means you must be told clearly and fully all the important facts you need to make an intelligent decision about what treatments to have, where to get them, and from whom.

On your return to more regular medical appointments, if you and your health have not changed significantly during the difficult pandemic times, you should ask lots of questions if your doctor suddenly decides you need a battery of new tests or a raft of repeat or unfamiliar procedures. Why? You should inquire, just as you would when you take the vehicle, which you have mostly kept parked in the garage and added only a few miles on, to a dealer-mechanic who wants to run the budget-busting “works” on your favorite ride.

By the way, just as many Americans saw their transportation costs plummet during the pandemic, the country recorded another fiscal rarity: The country in 2020 “bent the curve,” seeing the first year in at
least six decades in which America’s health care spending went down. It cratered early in the pandemic and recovered — some — in subsequent months. But not close to previous norms. As the Peterson-Kaiser Family Foundation Health System Tracker reported:

“[O]verall health spending appears to have dropped slightly in 2020 …  As of December 2020, health-services spending was down about 2.7% (seasonally adjusted annual rates) and it remained suppressed in January 2021. When adding in spending on prescription drugs, total health spending was down by just about 1.5% as of December 2020 compared to the same time in 2019. The U.S. GDP fell by 3.5% by the end of 2020, meaning that, although health spending dropped, it likely represented a larger share of the economy than in past years.”

The pandemic itself, of course, inflicted staggering economic damage, estimated by respected economists at mid-2020 at $16 trillion. The U.S. health system took a huge share of the fiscal hit, with uneven and disparate harms. Big academic medical centers and hospitals, including the wealthiest institutions and health systems, weathered the pandemic’s economic shocks far better, say, than their small, poor, and rural counterparts. Facilities serving communities of color struggled even more. Pediatricians, primary care practices, and dentists were slammed when public health restrictions slashed business, especially in comparison with, say, surgeons and elite specialists of various types, who saw their patient traffic rebuild and relatively quickly.

What are our health priorities?

Brody and others have pointed out that recent experiences with the coronavirus may compel patients and politicians to reconsider the country’s health priorities, especially when doctors who provide so many patients with valuable but general care can’t make ends meet and quit or become minions in groups owned and run by investors with max profits in mind.

Will health programs also recognize that prevention can be much cheaper than treatment? Will private and government insurers alter their policies and cover or pay more toward care now excluded for services by the likes of dietitians, physical therapists, and counselors? Would it be wiser to spend a little more on nutrition education, meal plans, exercise programs, and stress counseling, and much less on pricey procedures like electrocardiograms, angiograms, and treadmill tests? Could we spend a little more to crack down further on smoking and vaping, rather than forking over a lot more for lung-cancer chest X-rays or low-dose computed tomography?

Here’s hoping, of course, that you find a happy medium — that you take steps yourself, with your loved ones, and with your doctor for safe, effective, and affordable health care, especially so you and yours stay healthy throughout 2021 and beyond!

It’s unwise to defer care for kids, the chronically ill, and the sexually active

While doctors, clinics, and hospitals have pressed all patients, after a year of the coronavirus pandemic, to resume more normal and regular medical treatment, experts have tried to give an extra nudge to people with specific conditions and extra risks to stop canceling or postponing health appointments.

Parents, for example, should ensure their children not only are healthy now but also are developing mentally and physically as they are supposed to — meaning they need to see their pediatricians, the kid clinicians emphasize. As the American Academy of Pediatrics reported:

“Since the onset of the pandemic, a significant drop in well-child visits has resulted in delays in vaccinations, delays in appropriate screenings and referrals, and delays in anticipatory guidance to assure optimal health. Pediatricians rapidly adapted to provide appropriate elements of well exams through telehealth when clinically warranted and also implemented measures to provide in-person care as safely as possible. While outpatient visits to adult primary care physicians have rebounded to near pre-pandemic levels, pediatric visits and immunization rates have been slower to rebound …

“Primary care pediatricians are prepared to ensure all newborns, infants, children, and adolescents are up to date on their comprehensive well-childcare, inclusive of appropriate screenings, complete physical exam, laboratory exams, fluoride varnish, and vaccines.”

Public health officials have expressed concern that, as schools reopen, youngsters not current on their vaccinations may spread measles, mumps, and other common but preventable childhood illnesses. Such outbreaks would be a nightmare for educators, who have labored to safeguard kids from the coronavirus so they could return to in-person or hybrid learning.

For grownups with chronic conditions, it may be past time for them to renew normal care.

These common disorders, including, cancer, diabetes, high blood pressure, stroke, heart disease, respiratory diseases, arthritis, obesity, and oral diseases, can lead to hospitalization, long-term disability, reduced quality of life, and death. In fact, “persistent conditions are the nation’s leading cause of death and disability,” researchers have found.

The conditions can be kept in check with sustained treatment and prescription medications. But patients have put themselves at risk by failing to maintain needed regimens of care. As NPR reported:

“If you’re already taking medicines for a [chronic] health condition, now’s not the time to avoid seeing the person who prescribed them … Reach out to that doctor or other health care provider now — chances are you’ll need an office visit if you haven’t had one since the pandemic started, and it may be unsafe for you to keep postponing that appointment. That’s especially true for diagnoses such as heart failure, chronic lung and kidney diseases or diabetes — illnesses that can have serious complications if they’re not managed closely.

“It’s worth noting that 43% of patients with diabetes surveyed by the American Diabetes Association in December said they’ve delayed seeking routine medical care during the pandemic … And while some routine care gaps can be filled with virtual visits to help you manage conditions from home, there are important things that can’t be done online or by telephone — vaccinations, lab tests, wound care and other important maintenance exams, for example, that are vital for patients who have a chronic illness.

“‘This is no longer a couple of months’ delay here and it is too long a time to go without the right care,’ says Dr. Robert Gabbay, an endocrinologist and the chief science and medical officer of the American Diabetes Association. He warns of the long-term problems that can outrun treatment if caught too late. ‘The complications of diabetes — eye disease, kidney disease, nerve damage — is really all about diagnosing people early to then intervene to ensure that things don’t get worse,’ Gabbay [said]. ‘So, people could be having very active disease, not knowing, and this is a real concern.’”

Experts also have expressed growing worry about men and women who stayed sexually active with people outside their households during the pandemic. Federal officials have reported declines in reported cases of sexually transmitted diseases, which typically number around 20 million annually. But the dip may be due to patients avoiding STD testing, treatment, and talking to trusted health workers about sexual activity, experts say. As NPR reported:

“It’s as important as ever to talk to a health care provider about how to manage your sexual health … they may recommend an appointment … for testing — and that’s a test you don’t want to miss. If you’ve got new genital or urinary symptoms or think you’ve been exposed to a sexually transmitted infection, holding out for the pandemic’s end is not an option. That’s also the case for patients who are taking medicines to treat or prevent HIV — preventive medications called preexposure prophylaxis, or PrEP — so regular visits for the required lab tests that ensure the treatment’s safety should be prioritized. The same rules apply for some birth control methods. Long-acting birth control devices, such as intrauterine devices (IUDs) and other implants, have expiration dates. If you’re using one of these methods, do check with your health provider to see if you’re close to that date — and don’t delay an appointment if the device needs to be replaced.”

Medicine’s unexpected push for technology and innovation

When patients stopped or slashed their medical care due to the coronavirus pandemic, they may have spurred mainstream medicine’s adaptation of technology and different ways to deliver health care.

Health care reformers have zoomed in, for example, on significant new information about the value of telemedicine — online video consultations that burgeoned in a time when patients dreaded going to doctors’ offices or hospitals. As Drs. Ezekiel J. Emanuel and Amol S. Navathe of the University of Pennsylvania opined in the New York Times:

“Telemedicine is now everywhere. For years doctors resisted telemedicine, either because it was too hard to learn or, worse, because they made more money from an in-office visit. Last year just 22% of family physicians surveyed used video visits, according to the American Academy of Family Physicians. Overnight, the pandemic forced doctors to close their offices and shift almost exclusively to telemedicine. For normal pregnancies, many obstetricians are now doing most prenatal check-ins with virtual visits. Dermatologists are diagnosing less threatening skin conditions by using cellphone cameras.

“This is crucial because telemedicine is cost-efficient for matters that do not need physical contact and easier to work into patients’ daily life, and it frees up office visits for patients with complex conditions. It also makes it easier for doctors to provide after-hours care, reducing costly emergency room and urgent care clinic visits.”

President Trump became an enthusiast of telemedicine, and his administration expanded Medicare coverage for its more robust use.

But as time passes, some of the sheen of this technological advance has diminished. As researchers in Pennsylvania reported in their study published online in a part of the Journal of the American Medical Association:

“Although the U.S. logged an estimated 1 billion telemedicine visits in 2020, a recent retrospective cohort study found that lower-income, non-English-speaking, and older patients had increased barriers to engaging in care via telemedicine during the Covid-19 pandemic, suggesting that the rapid adoption of technology might have exacerbated existing inequities.”

The researchers noted that online connectivity may be a fundamental hurdle to equitable use of telemedicine, noting that “the Federal Communications Commission estimates that about 21 million Americans don’t have access to the internet in their homes. Other sources estimate it is closer to 162 million.”

Researchers at the independent, nonpartisan RAND Corporation reported on another troubling telehealth wrinkle — it too often involved telephone calls and not online video for poorer patients:

“Telehealth use has surged during the pandemic at clinics that serve lower-income Americans, which allowed the clinics to maintain access to care at a time when many other health care organizations saw significant declines in utilization, according to a new RAND study. However, most of the telehealth appointments have been audio-only visits, which may pose challenges in the future if payers consider dropping reimbursement for such services.”

With doctors’ offices, clinics, and hospitals often off-limits to patients during the pandemic, medicine saw a renaissance in home treatment, experts say. As the doctors wrote in their New York Times Op-Ed:

“[H]ospitals have substantially increased the threshold for hospitalizing patients so more beds are available for Covid-19 patients. Only the sickest patients are admitted. That has drastically accelerated a decades-long decline in the number of hospitalizations as procedures like chemotherapy are shifted to clinics and the use of home care increases. Treatment for chronic conditions, such as heart failure, pneumonia, and emphysema, has been slowly moving from doctors seeing patients in hospitals, to visiting nurses caring for patients at home. In general, patients treated at home recover faster, with fewer tests, fewer readmissions and higher satisfaction. And care in the home typically costs less than care in hospitals. Covid-19 has shown that even more patients can be treated well without being hospitalized.”

The pandemic also inarguably raised public consciousness about not only medical testing but also its administration at different sites beyond hospitals and clinics, including specialized centers. Patients, with the rising popularity of mail-in genealogy tests, also grew familiar in 2020 with home coronavirus tests. They made ubiquitous medical gear like fast-reading digital thermometers and blood-oxygen meters.

The U.S. health care system already had undergone a pre-pandemic explosion of satellite, retail centers for emergency, urgent, and routine treatment, as well as specialized surgeries and other procedures. Will fast-growing home care now speed the obsolescence of dominance by giant hospitals and academic centers? Patients were cooling on them already, because they were too far away, too sprawling, and lacked conveniences like easy parking.

Their costs also can be steep because they carry so much overhead — so much so that they can try to stick patients with tacky expenses like “facility fees.” How long will consumers put up with these charges, which one patient reported on by the Kaiser Health News service led to her costs increasing 10 times for a routine, regular procedure she had to undergo.

Recent Health Care Blog Posts

Here are some recent posts on our patient safety blog that might interest you:

  • The University of Southern California apparently has set a record — one which parents should pray no college has reason to challenge and for which the educators and leaders at the Los Angeles campus should be ashamed. The Trojans will pay $1.1 billion to settle lawsuits over the actions of Dr. George Tyndall, who was the lone gynecologist for young women treated in the student health service. The school has admitted that he saw 17,000 patients in his three decades at the school and sexually abused many of them.
  • Churn may be a wonderful word when discussing fresh milk, heavy cream, and butter. But it can be a nightmare term for the too-common, rapid, and lethal turnover that occurs in health staff at nursing homes and other long-term care facilities. Personnel turnover left the aged, injured, and ailing residents at care centers, with an average annual health staff churn-rate of 128% and some facilities hitting as high as 300%, even more vulnerable during the coronavirus pandemic, a new study reported.
  • Although the Biden Administration may be winning Americans’ approval for its battle against the coronavirus pandemic, drug abuse experts have expressed rising worry that federal efforts are lagging in the fight against a rising health menace: the resurgent opioid abuse and drug overdose crisis. While overdoses for the first time might claim 100,000 U.S. lives in a single year, the national campaign to quell the opioid crisis, a top priority not that long ago, has become almost an “afterthought” for policy makers in Washington, D.C., the medical news site Stat reported.
  • It’s long been routine, if often controversial, for operating rooms to welcome medical device sales people and surgical trainees to watch the work of surgeons and nurses. But now the University of Missouri health system may have reset the bar with its $16.2 million settlement with almost two dozen patients over questionable knee surgeries. The contested procedures were performed in part by a veterinarian.
  • It’s not an invitation to pile on the ice cream, cake, and candy. But older adults may get to say pshaw to the finger-wagging they may have endured from doctors and loved ones about their raised blood sugar levels and the condition that specialists ginned up to caution them about it: prediabetes. As the New York Times reported, a newly published study by researchers at Johns Hopkins and elsewhere looked at data over six years on almost 3,500 older patients with elevated blood sugar measurements and found they “were far more likely to have their blood sugar levels return to normal than to progress to diabetes. And they were no more likely to die during the follow-up period than their peers with normal blood sugar.”
HERE’S TO A HEALTHY 2021!

Sincerely,

Patrick Malone
Patrick Malone & Associates

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